m.sc echocardiographysvimstpt.ap.nic.in/edu/curr_files/echo.pdf · ultrasound physics and...

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SRI VENKATESWARA INSTITUTE OF MEDICAL SCIENCES

TIRUPATI – 517 507 (A University established by an act of Andhra Pradesh State Legislature)

PG Programme in Allied Health Sciences

M.Sc Echocardiography

TIRUMALA TIRUPATI DEVASTHANAMS

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INDEX

S.No PARTICULARS Page No

1 General Regulations 3

2 Teaching hours & Examination pattern 3&5

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Syllabus for M.Sc Echocardiography

1st year

Embryology & Ultrasound Physics

Clinical Cardiology

Ischemic & Valvular heart disease

Epidemiology & Biostatistics

Ethics in Echocardiography

2nd Year

Paediatric Echocardiography

Echocardiography in Myocardial, Pericardial, Cardiomyopathy

Aortic and systemic disorders & Non Cardiac Diagnosis

Recent Advances & 3D Echo

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4 Monitoring Learning progress 34

5 Log book, Transcript 39

6 Model Paper 45

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General Regulations

1. Title of the Course Master of Science degree in Echocardiography

2. Duration of the Course The duration of the course shall be 2- years on full time basis

3. Eligibility for Admission

a) B. Sc in Cardiovascular Technology (3 yrs) (or)

b) B.Sc Degree + 2 years PG diploma in ECG & CVT + 3 years Experience. Three years of Experience post 2 years Diploma in cardiovascular technology. Post general B.Sc. Degree from reputed institution on regular basis. correspondence course will not be considered.

4. Selection Criteria Selection shall be based on the academic merit/entrance test conducted in the qualifying exam.

5. Admission schedule : a) Commencement of Course: August every year b) The admissions are closed by 30th September or 60 days from the date of commencement of

the programme.

5. Medium of instruction.

English shall be the medium of instruction for the subjects of study as well as for the Examination.

6. Course of study

The course shall be pursued on full time basis. In the end of first year there shall be an examination. Students shall be posted to SVIMS and SPMC hospitals during the practical hours.

Subjects for study and teaching hours for first year and second year of the PG courses are shown below.

Distribution of Teaching Hours First Year

S.No. Main subject Theory No. of Hours

Practical No. of Hours

Total

1. Embryology & Ultrasound Physics 46 120 166 2. Clinical Cardiology 47 120 167 3. Echocardiography for Ischemic/Valvular Heart

Disease 57 140 197

4. Epidemiology & Biostatistics 60 - 60 5. Subsidiary subject:

Medical Ethics 10 - 10

Total: 220 380 600

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Second year

S.No. Branches Theory No. of Hours

Practical No. of Hours

Total

6. Paediatric Echocardiography 46 140 186 7. Echocardiography in Myocardial, Pericardial,

Aortic and Systemic Disorders& Non Cardiac Diagnosis

47 125 172

8. Recent Advances 47 125 173

Total: 140 390 530

8 a) Attendance: A candidate is required to put in minimum 80% of attendance both in theory and practical

separately of each paper before admission to the university examination. Participation in NCC, NSS, sports and games, educational tours, professional meetings and conference or other co-curricular activities representing the institution/university will not count as absence.

b) Condonation for lack of attendance: The condonation of attendance on medical grounds or on absence under extraordinary

circumstances to those who are having the attendance between 70% and 79% in each paper will be granted in genuine cases. The students who have shortage of attendance in the particular papers have to apply to the controller of examinations, indicating the reasons for shortage of attendance. The representation to be forwarded by the HOD & Prof. i/c AHS. If the reason is on the medical grounds, the relevant medical certificate has to be enclosed to the representation. If any student falls below the 70% of attendance, he/she will not be allowed to write the university examinations.

9. Scheme of examination a) The examination for the degree shall consist of written papers, practical and oral. b) There shall be two examinations viz. Preliminary and final. The preliminary

examination shall be taken at the end of the first year. The final examination shall be taken at the end of 2nd year.

c) The examination shall be conducted ordinarily twice a year, viz. July/August and January/February.

Preliminary Examination

This consists of theory, practical and oral. There will be separate papers for each specialization.

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University Examination and Distribution of marks First year

S.No Subjects Paper Theory Practical (Marks)

Viva Grand Total

IA UE IA UE 1. Embryology & Ultrasound

physics I 20 80 15 60 25 200

2. Clinical cardiology II 20 80 15 60 25 200

3.

Echocardiography Ischemic/valvular heart disease

III 20 80 15 60 25 200

4. Epidemiology & biostatistics IV 20 80 - - 100 Total 700

Second year

S.No Subjects Paper Theory Practical (Marks)

Viva Grand Total

IA UE IA UE 5. Pediatric Echocardiography V 20 80 15 60 25 200 6. Echocardiography in

Myocardial, Pericardial, Aortic and Systmic Disorders & Non cardiac Diagnosis

VI 20 80 15 60 25 200

7. Recent advances VII 20 80 15 60 25 200 8. Dissertation 100 50 150

Total 750 Dissertation

The student should submit dissertation one month before the final examination. Those students who have not submitted the dissertation shall not be allowed to appear for the final examination. The dissertation shall be assessed at the time of orals by all the examiners.

The dissertation shall be written under the following headings:

Introduction; Aims or objectives of study; Review of literature; Materials and methods Results; Discussion; Conclusion; Summary; References; Tables; Annexure

The written text of dissertation shall not be less than 50 pages and shall not exceed 100

pages excluding references, tables, questionnaires and other annexure. It should be neatly typed in double line spacing on one side of paper (A4 size, 8.27” x 11.69”) and bound properly. Spiral binding should not be done. A declaration by the candidate that the work was done by him/her

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shall be included. The guide and head of the department shall certify the bonafide of the dissertation.

Three copies of dissertation shall be submitted to the university through proper channel along with a soft copy (CD), one month before the final examinations.

10. Internal assessment (IA): a) A student must secure at least 35% marks of the maximum marks fixed for internal

assessment in a particular subject to be eligible to appear for the university examination of that subject.

b) There shall be three internal assessment tests and the average of these tests shall be considered for awarding final marks.

c) If the candidate is absent for any of the exams, the marks in that exam shall be taken as zero.

d) The computed internal assessment marks as per the regulation 10 a) & b) shall be sent to the controller of exams 15 days before the commencement of the University exam.

e) The internal assessment marks should be signed by the concerned teaching faculty or HOD and counter signed by the HOD before being forwarded to the Controller of Examinations.

f) For those who failed in internal assessment test/s, have to reappear as per the regulation 9 a) & b) before he/she appears for the university examination.

g) For those who want to improve their marks in internal assessment tests, they can appear again as per the regulation 9 a) & b). For such students, the internal assessment marks of the student at the time of first appearance will be compared with the marks obtained at the present appearance and the higher of the two will be taken as his/her internal assessment marks.

11.Minimum for a pass

a) 35% in internal assessment of each theory paper and practicals/viva voce b) 40% in each theory paper of university examination. c) 50% on the total marks of theory university examination and internal assessment

clubbed together, applicable to each paper. d) Where, viva voce involved which is part of theory examination, 50% on the total marks

of theory university examination, internal assessment and viva voce clubbed together, applicable to each paper.

e) Where there is no internal assessment marks, 50% on the total theory marks, 50% in practicals/viva voce applicable to each subject.

Note: For 2 year PG course, where any paper contains both theory and practicals/viva voce, the student has to pass both theory and practicals/viva voce, if any student pass in theory examination and fail in practicals/viva voce examination or vice versa, the student concerned has to appear again for both theory and practicals/viva voce examination.

12. Classification of successful candidates Percentage of Marks for declaring Class:

Distinction - 75% and above of the total marks.

First Class - 65 - 74% of the total marks.

Second Class - 50- 64% of the total marks.

Pass Class - If the student does not pass all the subjects within

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the duration of the course, the class will not be awarded and the final results will be declared as “Pass”. Those who have break in the middle of the course due to attendance shortage, it will be taken into consideration as not completed within the duration of the course and the final results will be declared as “Pass”.

13. Reappearance

The student has to pass both theory and practicals/via voce, if any student pass in theory examination and fail in practicals/viva voce examination or vice versa, the concerned student has to appear again for both theory and practicals/viva voce examination.

14. Carry-over Provision

The students are permitted to complete the course period irrespective of their success in the preliminary part. However, the final results will be kept under “withheld” until he/she passes all the previous papers”.

15. Maximum duration for completion of course

A candidate shall complete the course within four years from date of admission.

Failing which, the candidate will be discharged.

16. Eligibility for award of degree

A candidate shall have passed in all the subjects of first and second year to be eligible for

award of degree.

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M.Sc. ECHOCARDIOGRAPHY FIRST YEAR

Course content (Syllabus) Theory

Paper I: Embryology and ultrasound Physics Total hours: 47Hrs Unit No Unit title

Unit objectives Content Hours

Method of evaluation

Orientation and introduction to the course

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1 Early development of embryo

mitosis, -meosis -Oogenesis -spermatogenesis -fertilization-formation of germ layers-formation of embryonic disc-placental formation

8 Sessional examination

2 Early blood vessel formation

Intra embryonic blood vessel -extra embryonic blood vessel


3 Development of Heart tube formation

-cardiac loop formation -interatrial septum formation, -interventricular septum formation -atrial formation -ventricular formation -formation of the cardiac valves -formation of the great systemic veins-aortic arch formation

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4 Basics of

ultrasound Ultrasound physics and

instrumentation

Physical principles, -The transducer, Imaging by ultrasound –Image optimization & equipments -Signal processing -Tissue harmonic imaging-Artifacts


5 Doppler Principles of Doppler ultrasound -Doppler formats -CF imaging -Doppler artifacts-Tissue Doppler imaging-Doppler

10 Sessional Echocardiography examination

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application -Speckle tracking -Tissue characterization -The digital echo Lab –Storage & retrieval of echo Images, Post study processing and approaches to AFI,-Biological Effects of US

6 Specialized Echocardiographic Techniques and

methods

Hemodynamics, Use of echo to assess cardiac hemodynamics and guide therapy -Evaluation of 3D Echo, Transducer technology,


6A Basics of 3D US

Beam forming and rendering 3d quantification, 3d examination protocol and approach

6B TEE

Instrumentation and Examination-TEE views-complication and safety consideration

7 Echocardiographic Cardiac LV systolic Function, LV diastolic Function, LA, RA RV Function, Echo in ICU, operative, pre-operative application

7 Sessional examinations chambers examination Stress

Echocardiography

Methodology -Pharmacological stress echo-Interpretation -Stress echocardiography in valvular heart Disease

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Paper II: Clinical cardiology Total hours: 47 Unit No Unit Title Unit Contents Hours

Method of Evaluation

1 Introduction and - 1 Sessional basics examination 2 Basic anatomy Anatomy of the heart 3 Sessional

and physiology -Lymphatic system ,Arterial and examination of the heart venous supply of the heart -Conduction system and basic electrophysiology

3 History and symptoms

Importance of history taking. -Causes of cardinal symptoms(Cardiovascular and non cardiovascular)- Assessment:-NYHA functional Classification -CCS functional classification -Specific activity scale -Chest Pain, Dyspnea, Shortness of breath, Palpitation, Fatigue, Syncope, Other symptoms: Hemoptysis, Hoarseness, Cyanosis, Fever


4 General Facial appearance -Gesture and signs -Oral cavity-Skin, Extremities-Peripheral edema

4 Sessional Examination examination

5 Arterial pulse Definition –Genesis -Wave pattern-Examination of arterial pulse-Characteristic features of pulse in common clinical conditions


6 Measurement of

Blood pressure Definition -Components and determinants of arterial blood pressure -Hypertension –Cause, mechanism and complications

2 Sessional Examination

7 Jugular venous

pressure Examination -Analysis-Abnormalities 2 Sessional

Examination 8 Cardiovascular

system examination

Inspection and palpation of the Precordium, Percussion


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Cardiac auscultation

Principle and Techniques First Heart sound Second heart sound Diastolic and systolic sounds Prosthetic valve sounds Extra cardiac sounds


9A Heart sounds

9B Heart Murmurs Definition -Mechanism Characteristics -Systolic murmur

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Diastolic murmur -Continuous murmur

11 Clinical Advanced ECG- ECG findings in Various cardiac Diseases -Clinical issues in ECG interpretation

4 Sessional Electrocardiogram examination

12 Cardiovascular Mechanism of action-Indications, Dosage -Precautions of cardiovascular Drugs, Atropine- Lidocaine -Procainamide- Verapamil and diltizem-Adenosine-Magnesium-Sodium Bicarbonate, Morphine-Calcium chloride -Dopamine- Dobutamine-Isoproterenol - Amrinone Sodium Nitroprusside -B- blockers: propranolol, Metoprolol, Atenolol-Diuretics -Thrombolytic agents: Streptokinase,Urokinase

10 Sessional pharmacology examination

10 Basic 3 Sessional investigation Examination

10A Chest X-ray Normal chest X-ray Lung and Pulmonary vasculature Cardiac size Abnormal Densities and lucency Cardiac malposition

10B Evaluating chest Lungs and pulmonary vasculature X-ray in heart Cardiac chambers disease: Great vessels Pleura and pericardium Implantable devices and other post surgical findings

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Paper III: Echocardiography for Ischemic and valvular heart disease Total hours: 57hrs

Unit No Unit title



1 Orientation and 1 Sessional introduction to the examination course

2 Ischemic Heart Echo cardiograp

hy and Coronary

artery disease

Understanding Coronary circulation, -Pathophysiology of coronary artery syndrome -wall motion scoring,-Detection and quantification of RWMA -Global ventricular function,-myocardial infarction

3 Sessional Disease examination

2A Echo assessment Morphology and coronary flow

reserve by TTE and TEE -Visualization of coronary arteries-Distal coronary Flow and coronary flow reserve

3 Sessional Coronary arteries examination

2B Congenital Anomalies and echo detection -Kawasaki Disease.

2 Sessional abnormalities examination

2C Echo in IHD Detection of Ischemia -Role in acute coronary syndrome -Role in ischemic cardiomyopathy


2D Chronic coronary artery disease

LV aneurysm -Pseudo aneurysm, Chronic remodeling, Mural thrombus -MR –Ischemic cardiomyopathy

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2E Echo in CCU Management of acute MI –

Pathophysiology and Echocardiographic correlation-Detecting and assessing MI,-correlation with coronary anatomy,-Prognostication following MI,-Complications of MI


2F Stress Fundamentals, Types of Stress

Echo-Interpretation of stress Echo-Technical aspects of non exercise test -Protocol, reversible ischemia detection, inducible ischemia/-viability and sensitivity and specificity -Assessment of disease significance and prognostic evaluation

3 Sessional echocardiography examination

2G Echocardiography Approach and clinical 2 Sessional

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evaluation of coronary blood flow

applications-Doppler evaluation of coronary flow -Technical aspects and detection-assessment and clinical application

examination

2H Newer techniques TDI, Strain, Strain rate, vector imaging, -Myocardial contrast Echo

2 Sessional and their examination application for IHD

2 I Surgical aspects of Role of Echo cardiographer- pre and post operative evaluation for CABG, Ischemic MR-repair vs replacement -Coronary anomalies echo aspects Dorr’s procedure

2 Sessional IHD examination

3 Valvular Heart Valve Mitral valve anatomy, -Mitral valve anatomy in surgeons view- Scallops of mitral valve in different echo views -Aortic valve anatomy -Tricuspid valve anatomy -Pulmonary valve anatomy

5 Sessional Disease anatomy examination

3A Echo in RF Acute vs chronic RF and valvular

involvement 2 Sessional

examination 3B

Mitral valve disease MVP, -Mitral regurgitation-etiology

Mechanism, Severity assessment -Sequential Evaluation. Chronic asymptomatic MR-Indication and Timing of Intervention for chronic valvular regurgitation-Assessment of Mitral stenosis -Etiology,-Severity assessment, Indication and valve assessment for Mitral Intervention


3C Aortic valve Aortic regurgitation -Etiology-Quantification of AR –severity - Timing of surgery - Aortic stenosis -Etiology, Valvular, subvalvular and supra valvular stenosis. -Severity assessment, Use of stress Echo and strain in evaluation of AS , Low gradient severe AS with depressed and preserved EF, Myocardial response to chronic AS.


3D Tricuspid valve

TR-etiology, Severity assessment, TS –etiology and severity assessment

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3E

Pulmonary valve

Pulmonary stenosis- valvular, supravalvular, Infundibular, Peripheral stenosis

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Pulmonary regurgitation - Etiology and severity assessment, Ross procedure

3F Pulmonary Etiology, PA pressure assessment by various methods

2 hypertension

3G Infective Dukes criteria Organisms, culture, Involvement of Valves, Indication for Echo, Prognostic stratification

3 Endocarditic

3H Prosthetic valves

Types of prosthetic valves, Echo assessment in various valves, Prosthetic valve dysfunction, Prosthetic valve IE, Pannus formation and dehiscence, Fluid dynamics of PV, Recognition and quantification of PV Dysfunction , 3DE and TEE evaluation

Paper IV: Epidemiology &Biostatistics Total hours: 60

Sl. No. Topics 60 Hours

1 Introduction Introduction to Biostatistics & Research Methodology, types of variables &scales of measurements, measures of central tendency and dispersion, Skewness and Kurtosis Rate, Ratio, proportion, incidence, prevalence and their meaning.

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2 Sampling

4 Random & non random sampling, various methods of sampling-simple random, stratified, systematic, cluster and multistage. Sampling and non sampling errors.

3 Basic probability distribution and sampling distributions Concept of probability distribution, normal, Poison and Binomial distributions, parameters and applications. Concept of sampling distributions. Standard error and confidence intervals.

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4 Tests of Significance

Basics of testing of hypothesis – Null and alternate, hypothesis, type I and type II errors, level of significance and power of the test, p value. Tests of significance (parametric) T – test (paired & unpaired), Chi square test and test of proportion, one way analysis of variance. Repeated measures analysis of variance. Tests of

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significance (nonparametric) – Mann Whitney U Test, Wilcoxon Test, Kruskal –Wallis analysis of variance Friedmann’s analysis of variance.

5 Correlation and Regression

Simple correlation – Pearson’s and Separman’s methods ; testing the significance of correlation co-efficient simple and multiple linear regression.

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6 Sample size determination General concept Sample size for estimating means and proportion, testing of difference in means, proportions of two groups and more than two groups.

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7 Study Designs Descriptive epidemiological methods – case series analysis and prevalence studies. Analytical epidemiological methods – case control and cohort studies, Clinical trials / intervention studies, odds ratio and relative risk, stratified analysis.

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8 Multivariate analysis Concept of multivariate analysis, introduction to logistic regression and survival analysis

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9 Reliability and validity evaluation of Diagnostic Tests Cronbach’s alpha and Test- retest methods 4

10 Format of Scientific documents Structure of Research protocol, structure of thesis/research report, formats of reporting in scientific journals. Systematic review and meta analysis.

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Suggested Reading

1. Surendar a Rao PSS and J Richard. Introduction Biostatics an Research Methods,

Prentice Hall of India (2006).

2. Abhaya Indrayan and Rajeev Kumar Malhotra, Medical Biostatics, 4th Editiin, CRC

Press (2017)

3. Indrayan and Satyanarayana, Biostatics for Medical, Nursing and pharmacy students,

prentice Hall of India (2006)

4. Sarma K.V.S, Statistics made simple – do it yourself on PC, 2nd edition, Prentice Hall

(2010)

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Subsidiary Subject

Ethics in Echocardiography: 10 HRS

(Should be taught to the 1st year students of M.Sc. Echocardiography)

Introduction: With the advances in science and technology and the increasing needs of the patient, their families and community, there is a concern for the health of the community as a whole. There is a shift to greater accountability to the society. It is therefore absolutely necessary for each and every one involved in the health care delivery to prepare them to deal with these problems. Other professionals are confronted with many ethical problems.

Standards of professional conduct are necessary in the public interest to ensure an efficient laboratory service. Every sinologists or sonographer should not only be willingly to play his part in giving such a service, but should also avoid any act or omission which would prejudice the giving of the services or impair confidence, in respect, for sinologists or sonographer as a body.

To accomplish this and develop human values, it is desired that all the students undergo ethical sensitization by lectures or discussion on ethical issues.

Introduction to ethics- What is ethics? General introduction to Code of Laboratory Ethics How to form a value system in one’s personal and professional life? International code of ethics

Professional Ethics- Code of conduct Confidentiality Fair trade practice Handling of prescription Mal practice and Negligence Professional vigilance Research Ethics- Animal and experimental research/ humanness Human experimentation Human volunteer research - informed consent Clinical trials Gathering all scientific factors Gathering all value factors Identifying areas of value – conflict, setting priorities Working out criteria towards decision ICMR/ CPCSEA/ INSA Guidelines for human / animal experimentation

Recommended reading Francis C.M., Medical Ethics, I Edition, 1993, Jay pee Brothers, New Delhi p189.

Good Clinical Practices: GOI Guidelines for clinical trials on Pharmaceutical Products in India (www.cdsco.nic.in) INSA Guidelines for care and use of Animals in Research – 2000.

CPCSEA Guidelines 2001(www.cpcsea.org). Ethical Guidelines for Biomedical Research on Human Subjects, 2000, ICMR, New Delhi.

ICMR Guidelines on animal use 2001, ICMR, New Delhi.

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PRACTICALS Paper –I: Embryology and ultrasound physics - 120 Hours 1. Echocardiographic demonstration: 5Hours

Candidate will be allocated equipment for demonstration of procedure of maintenance, Will be required to accompany service engineers and biomedical engineers during service visits and prepare at least six analyses of error and corrective actions taken Candidate will be required to perform rapid studies during OP peak hours under supervision and will participate in subsequent debriefing Will assist consultant in quality control exercise on a weekly basis.

2. Basic Echocardiographic principles: 5 Hours

Transducer selection Reduction of artifacts Obtaining optimal gray scale images Gain and depth controls Use of M-mode for temporal analysis of cardiac events and obtaining measurements Use of modalities to optimize colour flow such as colour maps, gain and scale Adjustments related to Doppler such as scale, PRF, sweep, angle correction Use of specialized techniques such as Tissue Doppler

3. Echocardiographic examination (10 Hours)

Will be required to perform calculations such as left ventricular mass and cardiac output, Calculation of cardiac mass, Doppler equations, stroke distance, converting velocity to flow, flow to volumes, cardiac output, shunt ratios, modified Bernoulli equation and intra-vascular pressures, assessment of left ventricular, left atrial, right ventricular, right atrial pressures Candidate would be required to store and retrieve studies of diagnostic quality-clinician satisfaction will be taken as a yardstick for performance Applications of principles to obtaining, storing and retrieving optimal images.

Clinical lab posting: 75 hours Students will be posted in the echocardiographic laboratory for the observation and to

develop practice in the routine cardiac investigation by echocardiography. Hands on practical work: 25hours

Students will be allowed to perform echocardiographic test independently under the supervision of the faculty to develop the skill and experience.

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Paper-II : Clinical cardiology 120 hours Clinical scenario given to the candidate for diagnosis and treatment of following disorders: 150 Hr

a. Unstable angina b. Myocardial infarction c. Left ventricular aneurysm d. Congestive heart failure e. Cardiac arrhythmia f. Atrial septal defect g. Ventricular septal defect h. Tetralogy of Fallot i. Hypertension

Cardiac Surgery 5 Hours Brief description of surgical steps involved in:

a. Coronary artery bypass grafting (on pump CABG) b. Mitral valve replacement c. Aortic valve replacement d. ASD closure e. VSD closure f. Off-pump CABG

Clinical lab posting: 75 hours Students will be posted in the echocardiographic lab, for the observation and to identify

the correlation of clinical diagnosis with the echo findings with the help of clinical features, blood investigations, ECG, X-RAY etc.

Students will be recruited to the operation theater for the observation of the cardiac surgeries and to understand various technics.

Students will be allowed to attend ward rounds with the cardiologists.

Students will be demonstrated for ACLS and BLS, and posted clinically in ICCU for the observation and experience.

Hands on practical work: 25hours

Students will be allowed to read ECG and report X-RAY, perform echocardiographic test independently under the supervision of the faculty.

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Paper –III : Echocardiography for Ischemic valvular heart disease - 140 Hrs

Ischemic and valvular heart disease, Echocardiography for ischemic heart disease 20 Hours

1. Understanding coronary circulation: Coronary anatomy and physiology, pathogenesis of atherosclerotic plaques, abnormalities of coronary perfusion, wall thickening

2. Wall motion scoring: Regional left ventricular function, relationship to vascular supply, use of tissue Doppler where indicated, Segmental analysis for wall motion defects, coronary artery territories, detection and quantitation of Ischaemic muscle-wall motion scoring,

3. Global ventricular function: Linear measurements: indirect M-Mode markers of left ventricular function; Assessing global LV function; Evaluation of diastolic function: Methods for evaluating diastolic function, Doppler evaluation of diastolic function, Evaluation of mitral inflow, determination of isovolumic relaxation time, Evaluation of pulmonary vein flow, Doppler tissue imaging, Assessment of overall performance of the Ischemic left ventricle-systolic and diastolic function, estimating volumes rule of disks.

4. Myocardial infarction: Detecting and assessing MI, co-relation with coronary anatomy, prognostication following MI.

5. Complications of MI: Aneurysm, pseudo aneurysm, Ventricular Septal Defect, thrombi-embolic potential, right ventricular involvement.

6. Stress echocardiography: Protocols for stress echocardiography, detection of reversible Ischemic, detecting inducible ischemia/viability, specificity and sensitivity

7. Newer techniques and their applications for IHD: Tissue Doppler, strain, strain rate and velocity vector imaging, studying myocardial perfusion using contrast echocardiography.

8. Surgical aspects of IHD-role of echo cardiographer: Pre and postoperative evaluation for Coronary Artery Bypass Grafting (CABG), Linear endo-ventricular patchplasty (Dorr’s procedure), Mitral regurgitation- morbid anatomy repair versus replacement decision/post-operative, coronary anomalies-echocardiographic aspects.

9. Recent developments in echocardiography for ischemic heart disease Textbooks and Reference Books:

1. Echocardiography by Feigenbaum (Latest Edition) 2. Echo manuals by Mayo Clinic Lecture notes. 3. Journal articles 4. Cardiology by Braunwald and Hurst (Latest edition)

Echocardiography for valvular heart disease 20 Hrs.

1. Hemodynamic information derived from echocardiography: Aortic flow, pulmonary flow, mitral flow, left atrial flow, tricuspid valve flow, cardiac output, regurgitant fraction shunt ratios, echocardiographic detection of stagnant blood flow, modified Bernoulli equation and intravascular pressures, echocardiographic findings with elevated left ventricular diastolic pressure, elevated left atrial pressures, pulmonary hypertension, right ventricular pressure, right atrial pressure.

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2. Mitral stenosis: Etiopathogeneisis, pathophysiology and hemodynamics, two-dimensional echocardiography in rheumatic mitral stenosis, congenital mitral stenosis, M-model echocardiographic appearance, transoesophageal echocardiography, three dimensional echo assessment for severity, anatomic determination of severity, exercise gradients, secondary features of mitral stenosis, Atrial fibrillation, secondary pulmonary hypertension, decision making regarding intervention; assessment for balloon mitral valvotomy-transesophageal echocardiography and its uses, post-procedural assessment,open mitral valvotomy versus mitral valve replacement- pre and post-operative assessment.

3. Mitral regurgitation: Doppler evaluation of mitral regurgitation, determination of mitral regurgitation, severity, Mitral valve prolapse and analysis of segments, Haemodynamics of MR, diagnosis of MR, assessing severity and secondary effects, pre-op, intra-op and post-operative, assessment for mitral valve repair, use of three dimensional echocardiography for mitral valve surgery, flail mitral valve, papillary muscle dysfunction. mitral annular calcium

4. Tricuspid valve disease: Anatomy and physiology of the healthy valve structural and functional changes in various disease states organic and functional involvement, tricuspid stenosis, tricuspid regurgitation and assessment of severity, approach to pulmonary artery hypertension.

5. Aortic stenosis: Etiopathogenesis and haemodynamics, sub-valvular, valvular and supravalvar lesions, cuspal morphology, diagnosis and assessment of secondary effects, time course and prognostication, pre-operative and post-operative assessment; Diagnosis, assessing mechanism and severity, assessing site, possible etiology, secondary effects such as LV function, impact on associated lesions and therapeutic approach

6. Aortic regurgitation: Etiopathogenesis and haemodynamics, secondary effects, establishing a diagnosis, evaluating the severity of aortic regurgitation, acute versus chronic aortic regurgitation, relevant aspects of left ventricular function, timing of surgery, pre-operative and post-operative assessment.

7. Pulmonary valve disease: Embryology, morphology, infundibular, valvular, supra valvular and peripheral pulmonic stenosis, evaluation of the right ventricular outflow tract, miscellaneous abnormalities of the pulmonary valve assessing severity of pulmonic stenosis, pre and post procedural assessment for pulmonary valvuloplasty, pulmonary regurgitation.

8. Prosthetic valves: Types and normal function of mechanical valves, stenosis regurgitation, use of tranesophageal echo for prosthetic valves, endocarditis: and its sequelae in native and prosthetic heart valves.

9. Recent developments in echocardiography for valvular heart disease Candidate would be allocated one or two patients/cases who are diagnosed with above (ischemic or valvular lesions) conditions, once in a week. They will be allowed to formulate the diagnostic question independently. The candidate will be analyzed by the faculty for the performance on the basis of diagnostic skill with the interpretation of the disease and looked for the knowledge on treatment modality. This will be followed by the brief discussion.

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Textbooks and Reference Books:

1. Echocardiography by Feigenbaum (Latest Edition) 2. Echo manuals by Mayo Clinic Lecture notes. 3. Journal articles Cardiology by Braunwald and Hurst (Latest edition)

Clinical lab posting: 75 hours

Students will be posted in the echocardiographic laboratory for the observation and to develop practice in the cardiac investigation in ischemic and valvular heart disease by echocardiography.



Second Year – Theory

Paper V: Paediatric Echocardiography Total hours: 46Hrs Unit No Unit title




2 Fetal cardiac Indications for fetal cardiac evaluation Fetal physiology-Indications for fetal echocardiography

2 Sessional Imaging examination

3 Echo examination A segmental approach to anatomy-Cardiac situs

- Ventricular morphology -Great arterial connections


4 Abnormalities of 1 Sessional RV inflow examination

5 Abnormalities of LV inflow

-Pulmonary veins - Left atrium-Mitral valve


6 Abnormalities of - Right ventricle-Pulmonary Valve-Pulmonary artery

2 RV outflow

7 Abnormalities of -Subvalvular Obstruction -Valvular aortic stenosis -Supravalvular aortic stenosis

2 Sessional LV outflow examination

8 Coarctation of 2 Sessional aorta examination

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9 Abnormalities of cardiac septation

Atrial septal defect- -Ventricular septal defect-Endocardial cushion defect


10 Abnormal Patent ductus arteriosus-Abnormal systemic venous connection Abnormalpulmonary venous connection-Abnormalities of the coronary circulation

2 Sessional vascular examination connections and structures

11 Cono truncal -Tetralogy of Fallot -Trans position of the great arteries,-Double outlet Right ventricle-Persistent truncus arteriosus-Aorto pulmonary window

3 Sessional abnormalities examination

12 Abnormalities of Hypoplastic left heart syndrome -single ventricle-Tricuspid atresia

3 Sessional ventricular examination development

13 M-mode and 2D in CHD

Basics of imaging and sequential segmental analysis -Left to right shunts -Atrio ventricular septal defect Congenital left ventricular and right vedntricular inflow anomalies -Left ventricular outflow tract obstruction. Echocardiographic anatomy of TOF with PS-Complete transposition of great arteries-AV/VA discordance-Pulmonary veins-Imaging of coronary anomalies and pulmonary arteries-Echocardiographic evaluation of aortic arch and its anomalies-Univentricular heart and heterotaxy syndrome.


14 3D echo in CHD

For quantification of ventricular volumes, Mass and function with CHD

LV volume, EF and Mass-RV volume, EF and Mass -Single ventricular volumes, EF and mass -3D analysis of regional wall motion, Synchrony and strain


15 Echo in the Simple congenital heart defects in adults Valvular heart disease Complex congenital heart

2 evaluation of adults with CHD

23

defects 16 Echo evaluation

during and after surgery

Systemic artery to pulmonary artery shunts Pulmonary artery bands

Fontan procedure -Right ventricle to pulmonary artery conduits


17 Echo evaluation

of acquired heart disease in

childhood

IE-Modified DukeCriteria for the diagnosis of IE Echo findings in Complications of IE . RHD-Johns criteria. Kawasaki disease - Coronary ectasia and aneurysms


Paper VI: Echocardiography in Myocardial, Pericardial, Aortic and Systemic Disorders & Non-Cardiac Diagnosis Total hours: 47

Unit No Unit title

Unit objectives Content

Hours



2 Echo in Definition and types of hypertrophy -Mid LV hypertrophic cardiomyopathy -Differential Diagnosis Treatment strategies

12 Sessional cardiomyopathies examination

2A Hypertrophic cardiomyopathy

2B Dilated Secondary findings in DCM -Etiology of DCM-Doppler evaluation of systolic and diastolic function -Therapeutic decision

cardiomyopathy

2C Infiltrative and Echo evaluation of RCM -Constrictive versus restrictive heart disease

Restrictive cardiomyopathy

2D Peripartum cardiomyopathy

2E Non-compaction LV/RV cardiomyopathy

2F Endocardial fibro

24

elastosis and hyper eosinophilic syndrome

3 Echocardiographic Echocardiographic 10 Sessional Differentiation of assessment of Examination ischemic and non ischemic and non ischemic ischemic

cardiomyopathy cardiomyopathy

-M-mode echocardiography -2D/3D /Doppler echocardiography - Distinction between ischemic and non ischemic dilated cardiomyopathy-Other non invasive imaging modalities

4 Pericardial disease Acute pericarditis -

Pericardial effusion , M-Mode and 2D echocardiography-Cardiac tamponade -Constrictive Pericarditis –Congenital anomalies-3D echo assessment in pericardial disease -2D versus 3D echocardiography

5 Sessional

examination

5 Diseases of the Echocardiographic

Evaluation -Aortic dilatation and Aneurysm -Marfan’ syndrome - Sinus of valsalva aneurysm -Aortic dissection -Aortic pseudo aneurysm, Aortic Trauma-Infections of the aorta- Aortic prosthesis thrombus -Takayasu arteritis

5 Sessional Aorta examination

6 Echo in systemic

disease Hypertension -DM-

Connective tissue /auto immune disease-Chronic liver disease-COPD -Pulmonary hypertension


7 Echocardiography in

the Elderly Aortic atherosclerosis and penetrating aortic Ulcer -Aortic valve Sclerosis -Aortic stenosis -Aortic


25

aneurysm- Aortic Dissection -LV Masses, Dimensions and function-Echocardiography in stroke patients -Mitral annular calcification-Prosthetic valves

8 Echocardiographic Echocardiographic assessment of cardiac tumors and masses-Primary Benign cardiac tumors -Malignant primary cardiac tumors

4 Sessional assessment of examination

Cardiac Tumors and Masses

Paper VII: Recent advances Total hours: 47

Unit No Unit title




2 Monitoring LV filling -Global systolicFunction, Regional wall motion abnormality-Use of TEE in operating room to monitor cardiac function in specific cardiac enteties

2 Sessional

ventricular function in examination

the operating room

3 Contrast ultrasound imaging, Method, Analysis and Application

Characteristics of microbubbles Ultrasonographic contrast agent, Ultrasonographic imaging technique-Method of analysis-Clinical applications of ultrasonographic contrast-Myocardial contrast echocardiography, Indications for use of ultrasound contrast-Safety of ultrasound contrast


4 Myocardial perfusion echocardiography

Acute coronary syndromes Assessment of myocardial viability Chronic coronary artery disease


5 Endothelial Endothelial function and Dysfunction -Role of Acetylcholine -Shear stress and

3 Sessional Dysfunction examination

26

flow mediated Dilatation-NO Release-Methodology for Assessing endothelial function-Analysis of shear stress and flow mediated dilatation response-Factors affecting the flow mediated dilatation-Limitations -Other non invasive methods to assess endothelial function

6 3D- Transthorasic 3D TEE Technology -Performing 3D TEE -Evaluation -Specific uses of 3D TEE

2 Sessional and TEE echo examination examination and performing 6A 3D TEE to evaluate 3D echo image optimization-

3D echo of the mitral valve -3D echo of the aortic valve-3D echo of the pulmonic valve -3D echo of the Tricuspid valve

2 valvular heart disease.

6B 3D TEE in operating Mitral Valve disease-Aortic valve disease-Tricuspid valve disease-Native valve endocarditis-Prosthetic valve dysfunction-Cardiac masses

2 room

6C 3D guidance of Fluoroscopy versus echocardiography in guiding percutaneous interventions-Transseptal puncture, Device closure of cardiac shunts-Occlusion of the LA appendage- Guidance for electrophysiology procedures, Miscellaneous procedures

4 Percutaneous procedures

7 Speckle tracking Cardiac muscular anatomy-what is strain-2D speckle tracking echocardiography-Image acquisition and processing - Clinicalapplication of 2D STE-3D speckle tracking echocardiography - Clinical applications of 3D STE-Limitation

3 Sessional echocardiography; examination clinical usefulness

8 Intra cardiac Equipment and the Catheters-

Imaging specification-clinical

2 Sessional echocardiography examination

27

applications-intra cardiac echocardiography during EP intervention -During structural intervention

9 Intravascular ultrasound imaging

Principles of Ultrasound -Technology-Image acquisition-Intravascular ultrasound examination Image interpretation -Utility of intravascular ultrasound in clinical practice


10

Peripheral vascular ultrasound

Ultrasound diagnosis of carotid artery diseases Ultrasound diagnosis of Femoral access complications


11 Advanced Non invasive Quantification Techniques in echocardiography

Clinical applications of advanced 3D echo quantification tools -RV quantification -Mitral valve assessment -Aortic valve assessment -Conclusion


12 Echocardiography in Women

Structural heart disease:-MVP, Mitral stenosis, Mitral annular calcification -Ischemic heart disease -Stress echocardiography -Polycystic ovarian Syndrome -Takotsubo cardiomyopathy-CHD -Echocardiography in pregnancy-Peripartum cardiomyopathy-Fetal echocardiography


13 Echo for the

Electrophysiologist

Echocardiography in SVT-Left atrium Atrial septum-Pulmonary veins-Inferior venacava-Echocardiography in VT-Echocardiography in cardiac Implantable electronic devices


28

14 Echo in life threatening conditions

Chest trauma-Penetrating chest trauma- Acute Mitral regurgitation Acute severe AR -Aortic dissection –Debakey classification -The Stanford classification Pulmonary thromboembolic Disease -Air embolism Hypovolemia -Large intracardiac thrombus

4

15 A Primer on cardiac Quantitative left and right ventricular assessment -Strain assessment LV structure -Myocarditis and Sarcoidosis-cardiac hypertrophy,Cardiomyopathies -Velocity Mapping, Flow and shunt Assessment -Valvular heart disease and prosthetic valves

3 Sessional MRI for the Echo examination cardiographer

16 Fetal echocardiography

Echocardiography in diagnosis of heart disease in pregnancy-Indication-Extra cardiac reasons and associations for fetal heart disease - Fundamentals of fetal cardiac imaging


PRACTICALS

Paper - V: Paediatric Echocardiography 140 HRS

40 Hours

1. Paediatric echocardiography: Segmental approach, Assessing visceral and cardiac situs, veno-atrial connection, atrio-ventricular and ventriculo-great artery relation, Ventricular loop, Great artery position, Aortic arch visualization.

2. Abnormalities of right ventricular inflow 3. Abnormalities of left ventricular inflow: Pulmonary veins, left atrium, and mitral valve. 4. Abnormalities of right ventricular outflow: Right ventricle, pulmonary valve, pulmonary

artery 5. Abnormalities of left ventricular inflow: sub-valvular obstruction, Valvular aortic

stenosis, supravalvular aortic stenosis.

29

6. Coarctation of the aorta 7. Abnormalities of cardiac septation: Atrial septal defect, ventricular septal defect,

endocardial cushion defect. 8. Abnormalities vascular connection and structures: patent ductus arteriosus, abnormal

systemic venous connections, abnormal pulmonary venous connections, abnormalities of the coronary circulation.

9. Cono-truncal abnormalities: Tetralogy of Fallot, transposition of the great arteries, double outlet right ventricle, persistent truncus arteriosus and aortopulmonary window. Candidate would be allocated one or two patients/cases who are diagnosed with above

conditions, once in a week. They will be allowed to formulate the diagnostic questions independently. The candidate will be analyzed by the faculty for the performance on the basis of diagnostic skill with the interpretation of the disease and looked for the knowledge on treatment modality. This will be followed by the brief discussion.


Students will be posted in the echocardiographic laboratory for the observation and to develop practice in the cardiac investigation of congenital heart disease by echocardiography.



Paper - VI: Echocardiography in Myocardial, Pericardial, Aortic and Systemic Disorders & Non-Cardiac Diagnosis -125Hrs

25 Hours

1. Hypertrophic Cardiomyopathy: Morphological variants, diagnosis, haemodynamics, echocardiography evaluation of hypertrophic cardiomyopathy, assessing intracavitary and outflow tract gradients in obstructive cardiomyopathy, Mitral regurgitation in hypertrophic cardiomyopathy, other variants of hypertrophic cardiomyopathy, mid-cavity obstruction, conditions mimicking hypertrophic cardiomyopathy, therapeutic decision making and monitoring in hypertrophic cardiomyopathy, evaluation of therapy, pre and post-procedural evaluation.

2. Idiopathic dilated cardiomyopathy: Diagnosis and differentiation from other disorders such as IHD, Doppler evaluation of systolic and diastolic function, secondary findings in dilated cardiomyopathy, etiology of dilated cardiomyopathy, determination of prognosis in dilated cardiomyopathy, pre and post-procedural evaluation for cardiac re-synchronization therapy. Overview of cardiac transplantation.

3. Restrictive Cardiomyopathy: Diagnosis and haemodynamics, infiltrative cardiomyopathies, miscellaneous- myocardial diseases in neuromuscular disorders, infectious agents and toxins.

30

4. Diseases of the pericardium: Pericardial effusion: Detection of fluid, diagnosis-pleural versus pericardial fluid, quantitation, loculated effusions, cardiac tamponade-diagnosis, haemodynamics etiology, pericardiocentesis, Constrictive pericarditits: Diagnosis and haemodynamics. Differentiation from restrictive Cardiomyopathy, pre and post-surgical evaluation. Miscellaneous: acute pericarditis, pericardial thickening, pericardial cysts, absent pericardium.

5. Diseases of the aorta: Aortic dilatation and aneurysms, Aortic dissection-diagnosis and classification, false aneurysms, aneurysms of the aortic sinuses-rupture,haemodynamics, pre-and postsurgical evaluation.Miscellaneous- rauma, infections, aorta-left-ventricular tunnel, atherosclerosis, echocardiographic evaluation, aortic dilation and aneurysm, marfan syndrome, Sinus of valsalva aneurysm, aortic atheroma. Role of trans-esophageal echocardiography.

6. Echocardiography in systemic disorders: Diabetes hypertension, renal failure, neurological conditions, collagen vascular diseases and so on.

7. Cardiac masses: Tumors and source of embolus: Normal variants and artifacts, cardiac tumors; primary tumors, metastatic tumors of the heart, secondary effects, Masses, extra cardiac masses, intra cardiac thrombi, ultrasonic typing, man-made objects in the heart; Intra-cardiac thrombi: left ventricular thrombi, left atrial thrombi, right atrial thrombi, spontaneous echo contrast.

8. Echo findings with altered electrical activation: Normal and abnormal depolarization and conduction of the cardiac impulse, bundle branch blocks and Wolf-Parkinson-White syndrome, ectopic rhythm-ventricular and supra-ventricular, pacemakers.

9. Recent developments in echocardiography in myocardial, pericardial, aortic and systemic disorders

10. Infective endocarditis. Candidate would be allocated one or two patients/cases who are diagnosed with above

conditions, once in a two week. They will be allowed to formulate the diagnostic question independently. The candidate will be analyzed by the faculty for the performance on the basis of diagnostic skill with the interpretation of the disease and looked for the knowledge on treatment modality. This will be followed by the brief discussion.

Textbooks and Reference Books: 1. Echocardiography by Feigenbaum (Latest Edition) 2. Echo manuals by Mayo Clinic Lecture notes. 3. Journal articles Cardiology by Braunwald and Hurst (Latest edition) Clinical lab posting: 75 hours

Students will be posted in the echocardiographic laboratory for the observation and to develop practice in the echocardiographic examination in myocardial, pericardial, aortic and systemic disorders.

Hands on practical work: 25hours Students will be allowed to perform echocardiographic test independently under the

supervision of the faculty to develop the skill and experience.

31

Paper- VII- Recent advances 125Hrs 25 Hours

1. Tissue Doppler(TDI) and Deformation Imaging Technical Principles of Tissue velocity, strain and strain rate imaging Introduction Tissue velocity imaging Pulsed wave tissue velocity imaging Color tissue velocity imaging Curved anatomical M-mode Concepts of strain and strain rate Definition of strain and Strain rate Estimation of strain and strain rate from ultrasound data Artifacts and methods to improve signal quality

2. Principles and different technique for speckle tracking Introduction Principles of speckle tracking Strain and strain rate assessment Torsion and twist

3. Application of echocardiography in hemodynamic evaluation Assessment of filling pressure at rest Heart failure and LV filling pressure Role of standard Echocardiography in Assessment of LV filling pressure Mitral inflow, Pulmonary venous flow Colour M-mode flow propagation velocity Role of TDI in Assessment of LV filling pressure Doppler estimation of LV filling pressure in AF

4. Assessment of LV filling pressure with strain 5. Assessment of Systolic Heart failure

Introduction Regional systolic and long axis function Assessment of LV filling pressure Tissue Doppler imaging in heart failure with MR Tricuspid annular Velocities and RV function

6. Assessment of Diastolic Heart failure Introduction Differential diagnosis in a patient with Heart failure and Ejection fraction Echocardiography as a tool for Assessment of heart failure

7. Assessment of cardiac dyssynchrony and its application Introduction Methods of Assessment of cardiac dyssynchrony by myocardial imaging RV pacing -induced systolic dyssynchrony Role of cardiac dyssynchrony, Assessment in cardiac resynchronization therapy: Tissue Doppler imaging

32

8. Ischemic heart disease

Experimental study on myocardial ischemia and viability using tissue Doppler and

deformation

9. Use of tissue velocity imaging during stress echocardiography

10. Tissue Doppler echocardiography in the assessment of Hypertensive heart disease

11. Constrictive Pericarditis versus Restrictive cardiomyopathy

12. Use of Myocardial imaging to identify and manage sub clinical heart disease in

thyroid and other endocrine heart disease

13. Myocardial imaging in valvular heart disease Myocardial imaging in

mitral valve disease Myocardial imaging in Aortic valve disease

14. Tissue Doppler Imaging and strain rate imaging to evaluate RV function.

15. 3 D Echocardiography Principles

& Clinical Application

16. Automated Functional Imaging

17. 3D TEE

Clinical Applications & Instrumentation

18. Cardiac resynchronization therapy

19. Contrast Echocardiography

20. Fetal Echocardiography.

Candidates will be trained by the faculty in the echocardiographic lab to obtain technical

skill on recent indices of Tissue Doppler imaging including strain and strain rate measurement.

Periodically one or two hours per month, candidates will be subjected to random cases for which,

the assessment will be carried out by applying all the Deformation techniques under the

supervision of the faculty and then the appropriate discussion is recruited to reduce the means of

error in the analysis.


Students will be posted in the echocardiographic laboratory for the observation and to develop practice in the echocardiographic examination for diagnosing subtle changes in the myocardium in systemic, valvular, congenital heart diseases. Observing the echo guided CRT analysis to understand the prognostication and to identify the responders.


Students will be allowed to perform echocardiographic test independently under the supervision of the faculty to develop the skill and experience

33

Section-III Minimum requirement of infrastructure, laboratory facilities and staff: (i) Basic Infrastructure: Institute should have its own hospital with full-fledged cardiology unit with the following facilities:

- 25 bedded cardiology / cardiac surgery services - Echocardiography laboratory with 4 echocardiography machines - Class room with capacity for 30 students, measuring 500 sq.ft - One departmental Seminar room measuring 250sq.ft for each branch with A.V

aids – OHP, Slide projector and computer with accessories are compulsory. LCD Projector (optional) other infrastructure criteria- Principals room, students common room, staff room, Library, office room, Store room, preparation room etc will be as per minimum criteria. Norms of B.Sc-Cardio vascular/Cardiac Care Technology course.

(ii). Infrastructure subject wise

- Anatomy laboratory - Physiology laboratory - Echocardiography equipments

i. Echocardiography machines – 4 ii. Transoesophageal echocardiography probes –01 iii. OPD case load for echocardiography – 50 / day iv. Cardiology OPD attendance – 100 / day v. Cardiology inpatient service minimum – 25 beds vi. Cardiac surgical case load – 01operations / day

Suggested Readings:

1. Feigenbaum Present / Latest edition 2. ‘Otto’ Text book of Echo 6th edition 3. Echo manual – Joe 4. Indian Text book of Echocardiograpy: Amuthan . V 5. Jaypee publishers : Text book of Echo : Navin C Nanda 6. 3D Echo : Dr Amuthan . V 7. Valvular Heart Disease : Dalen & Alpert 8. ‘Otto’ : 3 D TEE Primer 9. Echocardiography review Guide “Otto” 10. Atlas of 3 D Echo: Edward A. Gill 11. 3 D Echo: Takakhiro Shiota

34

SECTION- IV MONITORING LEARNING PROGRESS

It is essential to monitor the learning progress of each candidate through continuous

appraisal and regular assessment. It not only also helps teachers to evaluate students, but also students to evaluate themselves. The monitoring be done by the staff of the department based on participation of students in various teaching / learning activities. It may be structured and assessment be done using checklists that assess various aspects. Model Checklists are given in this Chapter, which may be copied and used.

The learning out comes to be assessed should include: i) Acquisition of Knowledge: The methods used comprise of `Log Book’ which records

participation in various teaching / learning activities by the students. The number of activities attended and the number in which presentations are made are to be recorded. The logbook should periodically be validated by the supervisors. Some of the activities are listed. The list is not complete. Institutions may include additional activities, if so, desired.

Journal Review Meeting (Journal Club): The ability to do literature search, in depth study, presentation skills, and use of audio- visual aids are to be assessed. The assessment is made by faculty members and peers attending the meeting using a checklist (see Model Checklist – I, Section IV) Seminars / Symposia: The topics should be assigned to the student well in advance to facilitate in depth study. The ability to do literature search, in depth study, presentation skills and use of audio- visual aids are to be assessed using a checklist (see Model Checklist-II, Section IV) ii) Teaching skills: Candidates should be encouraged to teach undergraduate medical students and paramedical students, if any. This performance should be based on assessment by the faculty members of the department and from feedback from the undergraduate students (See Model checklist III, Section IV) iii) Dissertation: Please see checklist IV and V in Section IV.

iv) Work diary / Log Book- Every candidate shall maintain a work diary and record his/her participation in the training programmes conducted by the department such as journal, reviews, seminars, etc. Special mention may be made of the presentations by the candidate as well as details of experiments or laboratory procedures, if any conducted by the candidate. v) Records: Records, log books and marks obtained in tests will be maintained by the Head of the Department and will be made available to the University.

Log book: The logbook is a record of the important activities of the candidates during his training;

Internal assessment should be based on the evaluation of the logbook. Collectively, logbooks are a tool for the evaluation of the training programme of the institution by external agencies. The record includes academic activities as well as the presentations and procedures carried out by the candidate. Format for the logbook for the different activities is given in Tables 1 and 2 of Section IV.

Copies may be made and used by the institutions.

35

Procedure for defaulters: Every department should have a committee to review such situations. The defaulting candidate is counseled by the guide and head of the department. In extreme cases of default the departmental committee may recommend that defaulting candidate be withheld from appearing the examination, if she/he fails to fulfill the requirements in spite of being given adequate chances to set himself or herself right. Format of Model Checklists

Checklist - I

Model Checklist for Evaluation of Journal Review Presentations Name of the student:___________________________________________ Date:__________ Name of the faculty/ Observer:___________________________

Sl No. Items for observation during presentation

Poor

Below

avera

ge

Ave

rage

Goo

d

Very

Goo

d

0 1 2 3 4

1 Article chosen was

2 Extent of understanding of scope & objectives of the paper by the candidate

3 Whether cross- references have been consulted

4 Whether other relevant references have been consulted

5 Ability to respond to questions on the paper /subject

6 Audio-visuals aids used

7 Ability to defend the paper

8 Clarity of presentation

9 Any other observation

Total score

36

Checklist - II

Model Check List for the Evaluation of the Seminar Presentations Name of the student:_________________________________________Date:____________ Name of the faculty/ Observer:_________________________________


Poor

Belo

w a

vera

ge

Ave

rage

Goo

d

Ver

y G

ood

0 1 2 3 4

1 Article chosen was

2 Extent of understanding of scope & objectives of the

paper by the candidate

3 Whether cross- references have been consulted

4 Whether other relevant references have been

consulted

5 Ability to respond to questions on the paper /subject

6 Audio-visuals aids used

7 Ability to defend the paper

8 Clarity of presentation

9 Any other observation

Total score

37

Checklist – III

Model Check list for Evaluation of Teaching Skill

Name of the student:___________________________________________Date:___________ Name of the faculty/ Observer:___________________________________

SL. No. Strong Point Weak point

1 Communication of the purpose of the talk

2 Evokes audience interest in the subject

3 The introduction

4 The sequence of ideas

5 The use of practical examples and /or

illustrations

6 Speaking style (enjoyable, monotonous, etc.,

specify)

7 Summary of the main points at the end

8 Ask questions

9 Answer questions asked by the audience

10 Rapport of speaker with his audience

11 Effectiveness of the talk

12 Uses of AV aids appropriately

38

Checklist - IV

Model Check list for Dissertation / Project Work Presentations

Name of the student:___________________________________________ Date:_________ Name of the faculty/ Observer:___________________________________

Sl No. Points to be considered

Poor

Belo

w a

vera

ge

Ave

rage

Goo

d

Ver

y G

ood

0 1 2 3 4

1 Interest shown in selecting topic

2 Appropriate review

3 Discussion with guide and other faculty

4 Quality of protocol

5 Preparation of proforma

Total score

Checklist – V

Continuous Evaluation of dissertation / project work By Guide/ Co-Guide Name of the student: ________________________________________Date:____________ Name of the faculty/ Observer:_________________________________


Poor

Belo

w a

vera

ge

Ave

rage

Goo

d

Ver

y G

ood

0 1 2 3 4

1 Periodic consultation with guide/ co-guide

2 Depth of Analysis/ Discussion

3 Department presentation of findings

4 Quality of final output

5 Others

39

Total score

Overall Assessment Sheet Date:

Check list No. Name of the students

A B C D 1

2

3

Course i/c Signature of the HOD Signature of the Prof. i/c AHS

The above overall assessment sheet used along with logbook should form the basis for certifying satisfactory completion of course of study, in addition to the attendance requirement. KEY Mean score: Is the sum all the scores of checklists 1 to 5 A, B, C: Name of the students LOG BOOK Table 1: Academic activities attended Name: Admission Year:

Date Type of activity, Specific Seminar, Journal club, presentation, UG teaching

Particulars

40

LOG BOOK Table-2: Academic presentations made by the student Name: Admission Year: Date Topic Type of activity, Specific Seminar, Journal

club, presentation and UG teaching

Management Information System Report

1. Name of the college imparting Echocardiography 2. Details of M.Sc.

Name of the Branch & Teaching faculty

Sanctioned Name of the subjects to be

Sl. No Admitted

Strength studied at 1st Year M.Sc.

1

2

3. No. of experiments/assignments conducted for 1st year M.Sc. Echocardiography

students Assigned by

Sl.No Branch Subject SVIMS Conducted % Remarks University

1. No Name

2

41

4. No. of theory classes conducted for 1st year M.Sc. Echocardiography students SVIMS

Sl.No Branch Subject University Conducted % Remarks Norms(25)

1. No Name

2.

3.

5. Number of theory and practical classes taken by 2nd year M.Sc. Echocardiography

students for under graduate program (Optional). 6. No. of Journal clubs department wise for 1st year and 2nd year M.Sc. Echocardiography

Students Total No. of students Norms for half Achieved % Remarks

Dept. Wise yearly Report Number Achievement

1st year M.Sc. Echocardiography

No.=

2 per candidate per year

2nd year M.Sc. Echocardiography

No.=

2 per candidate

per year

7. Number of seminars for 1st year and 2nd year M.Sc. Echocardiography students

Norms for half Achieve %

Total No. of students : 10 d Remarks

yearly Report Achievement

Number

1st year M.Sc. Echocardiography No.=10

2 per candidate

2nd year M.Sc. Echocardiography

No.= 08

2 per candidate

42

8. Number of interdepartmental meetings

Norms for half yearly Achieved % Remarks

Report Number Achievement 2 200% Interactive and productive

9. Number of visits to pharmaceutical industry/research center/hospital for 1st year & 2nd year M.Sc. Echocardiography students. Norms for half yearly Achieved % Remarks

Report Number Achievement

1 02 200 Educative & informative

10 Number of guest lectures for postgraduate Program

Norms for half yearly Achieved % Remarks

Report Number Achievement

2 03 150 Need focused and

educative

11. Number of research papers published in the year in the college –

12. Any other additional information such as consultancy/collaboration/conducting Seminars & workshop or attending seminar & workshops or conference

Sl. No. Subject No. of Contact

Hours Code Grade Remarks

1. Cardiac Embryology 20 C,L P 2. Fetal and neonatal

circulation 2 C,L P

3. Ultrasound physics and instrumentation

146 C,L,P,PL P

4. Clinical Cardiology 133 C,L,PL P 5. Cardiovascular

Pharmacology 10 C,L P

6. Electrophysiology 4 C,L P 7. Acute coronary syndrome 8 C,L P 8. BLS/ACLS 10 C,L,P P 9. Ischemic Heart Disease 17 L P

10. Valvular Heart disease 32 L P 11. Congenital Heart Disease 44 L P 12. Cardiac surgery 10 L,C, PL P 13. Echocardiography for

lschemic Heart disease 70 C,P,PL P

43

14. Echocardiography for Valvular heart disease

70 C,PL,P P

15. Echocardiography for Congenital Heart disease

140 C,PL,P P

16. Epedemiology and Biostastics

60 L P

18. Ehocardiography of other heart diseases

25 PL, C,L,P P

19. Myopericardial, Aortic, Systemic disorder & non cardiac diagnosis

137 C,L,P,PL P

20. Recent Advances 168 C,L,PL,P P 21 Medical ethics 10 L P 22 Fetal Echocardiography 2 L,P P 23 Peripheral Ultrasound 2 L,P P 24 Seminar presentation SS, I(G) Classes for

UG’s

25 Attending rounds with Cardiologists

10 C P

DESCRIPTION OF CODES C : Clinical Teaching

D : Demonstration of Faculty

I : Independent Work by Student

I (G) : Independent Work by Student Guided by Faculty

L : Classroom Lectures by Faculty

P : Hands on Practical Work by Students

SD : Self Directed Study by Student

SD (E) : Self Directed Study by Student with Faculty Evaluation SS : Student Conducted Seminars with Faculty Moderation and Evaluation by

Peers and Faculty PL : Practical / Clinical Lab Posting

Prof. & Course Incharge Prof.& HOD Prof. i/c AHS

44

CHECKLIST - I

Model Check List for Evaluation of Teaching Skill

SL.

Poor 0

Below average

1 Average

2 Good

3

Very good

4

No.

1 Communication of the purpose of the talk

2 Evokes audience interest in the subject

3 The introduction

4 The sequence of ideas

5 The use of practical examples and /or illustrations

6 Speaking style (enjoyable, monotonous, etc., specify)

7 Summary of the main points at the end

8 Ask questions

9 Answer questions asked by the audience

10 Rapport of speaker with his audience

11 Effectiveness of the talk

12 Uses of AV aids appropriately

CHECKLIST - II Model check list for Dissertation / Project Work Presentations

Points to be considered

Poor 0

Below average

1

Average 2

Good 3

Very Good

4

S. No.

1 Interest shown in selecting topic

2 Appropriate review

3 Discussion with guide and other faculty

4 Quality of protocol

5 Preparation of proforma

Total score

45

Overall Assessment of the student by the clinical/Lab work: Sl. No

Points to be considered Poor 0

Below Average

1

Average 2

Good 3

Very Good

4

Excellent

5 1 Attendance

2 Punctuality

3 Interaction with colleagues and support staff

4 Maintenance of case

records

5 Topic Presentation

7 Time sense

8 Knowledge

9 Rapport with patient.

10 Overall quality of work

Total Score - - - - - -

MODEL QUESTION PAPER

THEORY

Each theory paper will have 1) Essay questions – 03 nos. carrying 10 marks each - 03 x 10 = 30 2) Short answer questions – 10 nos. carrying 05 marks each - 10 x 05 = 50

Total = 80 Internal assessment = 20 PRACTICAL

(a) Preliminary: Internal assessment : 15

University examination : 60

Total = 75 (b) Viva = 25

m.sc echocardiographysvimstpt.ap.nic.in/edu/curr_files/echo.pdf · ultrasound physics and...

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